Alkaline (alkaline) phosphatase – the standard for ALP testing

Proven content

Alkaline phosphatase is an enzyme found in the membrane of many cells. A particularly high content of alkaline phosphatase concerns osteoblasts. This enzyme is excreted into the bile, so its concentration increases when the flow of bile from the liver to the intestines is impeded.

What is alkaline phosphatase?

A large number of alkaline phosphatase is observed in hepatocytes, renal tubules and intestinal epithelial cells (30% of total activity). This enzyme is excreted into the bile, therefore its concentration increases when the flow of bile from the liver to the intestines is impeded (with obstruction of the bile ducts, caused by urolithiasis or cancer). Less commonly, the source of alkaline phosphatase is neoplastic tissue (paraneoplastic symptom). The level of this enzyme depends mainly on age, so its greatest increase takes place during puberty (skeletal development). Alkaline phosphatase affects not only skeletal development, but is also responsible for the removal of pyrophosphates that inhibit bone development. A phosphatase test is performed when liver or bone disease (high levels) is suspected. Low levels of this enzyme are characteristic of genetic diseases (e.g. hypophosphatasia) causing bone deformation and, in extreme cases, death of the patient.

When do we do the alkaline phosphatase test?

1. Suspicion of diseases of the liver and bile ducts (hepatitis, differentiation of jaundice, damage to the liver by drugs, obstruction of the bile ducts as a result of urolithiasis or a neoplastic process).

2. Suspicion of skeletal system diseases (bone pain, pathological fractures in the course of cancer).

3. Disorders of calcium metabolism and vitamin D metabolism₃ (hyperparathyroidism, osteomalacia, in the case of symptoms: deformation of the skeletal system, bone radiographic changes and abnormal results of scintigraphy).

4. Suspicion of neoplasms producing alkaline phosphatase.

5. Diagnosis of parathyroid disease.

The test is also performed to monitor the effect of drugs on the functioning of the liver, especially those that are broken down by it, e.g. antidepressants, anti-inflammatory drugs, antibiotics or contraceptives. You can get a referral for the examination during the online consultation on the halodoctor.pl portal. Make an appointment today!

Alkaline phosphatase – study

Material for the study of alkaline phosphatase: serum.

Preparation for the test: on an empty stomach (at least 8 hours).

The course of the alkaline phosphatase test: one-time blood sampling from a vein in the arm.

Time to wait for the result: 1 Day.

In children, a small incision with a medicine knife (lancet) is made on the skin to collect a sample for examination.

Alkaline phosphatase – norms

Standards:

1. total activity – 580-1400 nmol / l / s,
2. bone fraction – 50-60% of total enzyme activity,
3. liver fraction – 10-20% of the total enzyme activity,
4. intestinal fraction accounting for 30% of total enzyme activity.

We read the alkaline phosphatase values ​​taking into account also age:

children up to 9 years:

1. 1-3 cans — 145-320 U/l,
2. 4-6 lats — 150-380 U/l,
3. 7-9 lats — 175-420 U/l,

boys 9-19 years of age:

1. 10-11 lats — 135-530 U/l,
2. 12-13 lats — 200-495 U/l,
3. 14-15 lats — 130-525 U/l,
4. 16-19 lats — 48-261 U/l,

girls 9-19 years of age:

1. 10-11 lats — 130-560 U/l,
2. 12-13 lats — 105-420 U/l,
3. 14-15 lats — 70-230 U/l,
4. 16-19 lats — 40-136 U/l,

adults:

1. 30-120 U/l.

Comments: The normal value of alkaline phosphatase is higher in children during adolescence and in pregnant women (the placenta secretes this enzyme).

It should be taken into account that reference values ​​for alkaline phosphatase may differ depending on the laboratory where the test was performed.

The results of alkaline forforase tests should be supplemented with the results of basic blood tests, such as blood count, cholesterol and sugar. You will find the package of these tests in the offer of the Comprehensive Rehabilitation Center.

Analysis of the results of alkaline phosphatase studies

A decreased alkaline phosphatase result may suggest:

1. celiac disease,
2. malnutrition,
3. cretinism,
4. zinc and magnesium deficiency,
5. scurvy,
6. milk-alkaline syndrome,
7. excessive supply of vitamin D in the body,
8. taking certain medications (e.g. corticosteroids),
9. Hypothyroidism,
10. osteoporosis in women who have been through the menopause
11. achondroplazję,
12. congenital hypophosphatization.

An increased alkaline phosphatase result suggests:

1. rickets,
2. hyperparathyroidism,
3. osteomalacia,
4. osteomyelitis,
5. increased activity in the case of bone metastases from prostate cancer,
6. Paget’s disease,
7. overactive thyroid gland
8. incomplete osteogenesis (the process of bone formation) associated with the healing of fractures,
9. sepsis,
10. possible kidney cancer,
11. heart failure
12. mononucleosis,
13. taking ergosterol,
14. Malignant Hodgkin,
15. late pregnancy,
16. liver problems (hepatitis, biliary obstruction, gallstones, liver cirrhosis, liver cancer, metastases from other parts of the body to the liver),
17. treatment of extensive fractures.

In turn, in women in the third trimester of pregnancy, as well as in premature babies and adolescents – a slightly elevated level of alkaline phosphatase should not cause concern.